title: The presence of total knee or hip replacements due to osteoarthritis enhances the positive association between hand osteoarthritis and atherosclerosis in women: the AGES-Reykjavik study.
abstract: OBJECTIVE
  This study examines the relationship between total knee replacements (TKR), total hip replacements (THR) or replacements of either joint (total joint replacement; TJR) due to osteoarthritis and atherosclerosis in a large population-based study.
  
  
  METHODS
  The participants were 2195 men and 2975 women, mean age 76 ± 6 years. The osteoarthritis data were analysed in relation to measures of atherosclerosis, including carotid artery intima media thickness and plaque severity (ultrasound), coronary and aortic calcifications (CT), cerebral white matter lesions (MRI) and a history of previous cardiac and cerebral events.
  
  
  RESULTS
  The prevalence of TKR was 223 (4.3%) and THR 316 (6.1%). The presence of TJR in women was associated with a non-significant trend towards increased carotid plaque severity, coronary calcifications and periventricular white matter hyperintensities (PVH) but not with a history of cardiac or cerebral events. No associations were seen in men. When TJR were grouped according to the presence or absence of hand osteoarthritis (HOA) there was a highly significant association in the order -TJR/-HOA < +TJR/-HOA < -TJR/+HOA < +TJR/+HOA, for carotid plaque severity, coronary calcifications and PVH.
  
  
  CONCLUSIONS
  The presence of TJR did not show a significant independent association with atherosclerosis but enhanced the strength of the positive association between HOA and subclinical atherosclerosis in women.
authors.affiliation: Landspitalinn University Hospital, University of Iceland, IS-108 Fossvogur, Reykjavik, Iceland. helgi@hi.is
authors.forename: Helgi
authors.initials: H
authors.lastname: Jonsson
authors.forename: Gudrun P
authors.initials: GP
authors.lastname: Helgadottir
authors.forename: Thor
authors.initials: T
authors.lastname: Aspelund
authors.forename: Gudny
authors.initials: G
authors.lastname: Eiriksdottir
authors.forename: Sigurdur
authors.initials: S
authors.lastname: Sigurdsson
authors.forename: Kristin
authors.initials: K
authors.lastname: Siggeirsdottir
authors.forename: Thorvaldur
authors.initials: T
authors.lastname: Ingvarsson
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Lenore
authors.initials: L
authors.lastname: Launer
authors.forename: Vilmundur
authors.initials: V
authors.lastname: Gudnason
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D019645:Arthroplasty, Replacement, Knee / Q000706:statistics & numerical data*; D050197:Atherosclerosis / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D050823:Hand Joints; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D010003:Osteoarthritis / Q000150:complications* / Q000453:epidemiology; D015207:Osteoarthritis, Hip / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000150:complications / Q000453:epidemiology / Q000601:surgery; D012737:Sex Factors